Kryssa Brainerd PEDS Exam I study guide Examination of lymph nodes, what is normal and what is not ·They are usually assessed when the part of the body in which they are located is examined.Palpate with distal portions of fingers with a gentle but firm pressure in a circular motion.Tilt the child’s head up slightly but do not overextend.There are submental, submandibular, tonsillar, and cervical nodes.The axillary nodes are under the child’s arms, have them relax them at their sides but slightly abducted.Inguinal nodes in inner thigh when child is in supine position.Not size, mobility, temperature, and tenderness, as well as any reports by parents regarding changes in size. ·In children, small non-tender moveable nodes are normal.Tender, enlarged, warm lymph nodes generally indicate infection or inflammation close to their location.Report these findings. Musculoskeletal exam- review gait ·Length, position and size should be symmetrical ·Joints should be stable, symmetrical, with full range of motion.With no crepitus or redness. ·Spine: in infants should be without dimples or tufts of hair, midline with an overall C-shaped lateral curve.Toddlers appear squat with short legs and protuberant abdomen.Preschoolers appear more erect than toddlers.Children should develop the cervical, thoracic curvature like that of adults.Adolescents should remain midline (no scoliosis noted) ·Gait:Toddlers and young children- bowlegged or knock-knee appearance is a common finding but feet should face forward with walking.Older children and adolescents should have a steady gait should be noted with even wear on the soles of shoes. Neurological assessment-especially primitive reflexes and cerebellar function ·Rooting reflex: turns head to side when check of mouth is touched.Birth to 6 months ·Palmar grasp: will grasp object when palm is touched.Birth to 4 months ·Plantar grasp:toes will curl downward when sole of foot is touched.Birth to 8 months ·Moro reflex (startle):Legs flex, arms and hands extend when startled by loud noises.Birth to 6 months. ·Asymmetric tonic neck reflex (fencer position):Extension of the arm and leg on the side when the head is turned to that side with flexion of the arm and leg of the opposite side.
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Examination of lymph nodes, what is normal and what is not
· They are usually assessed when the part of the body in which they are located is examined. Palpate with distal portions of fingers with a gentle but firm pressure in a circular motion. Tilt the child’s head up slightly but do not overextend. There are submental, submandibular, tonsillar, and cervical nodes. The axillary nodes are under the child’s arms, have them relax them at their sides but slightly abducted. Inguinal nodes in inner thigh when child is in supine position. Not size, mobility, temperature, and tenderness, as well as any reports by parents regarding changes in size.
· In children, small non-tender moveable nodes are normal. Tender, enlarged, warm lymph nodes generally indicate infection or inflammation close to their location. Report these findings.
Musculoskeletal exam- review gait
· Length, position and size should be symmetrical
· Joints should be stable, symmetrical, with full range of motion. With no crepitus or redness.
· Spine: in infants should be without dimples or tufts of hair, midline with an overall C-shaped lateral curve. Toddlers appear squat with short legs and protuberant abdomen. Preschoolers appear more erect than toddlers. Children should develop the cervical, thoracic curvature like that of adults. Adolescents should remain midline (no scoliosis noted)
· Gait: Toddlers and young children- bowlegged or knock-knee appearance is a common finding but feet should face forward with walking. Older children and adolescents should have a steady gait should be noted with even wear on the soles of shoes.
Neurological assessment-especially primitive reflexes and cerebellar function
· Rooting reflex: turns head to side when check of mouth is touched. Birth to 6 months
· Palmar grasp: will grasp object when palm is touched. Birth to 4 months
· Plantar grasp: toes will curl downward when sole of foot is touched. Birth to 8 months
· Moro reflex (startle): Legs flex, arms and hands extend when startled by loud noises. Birth to 6 months.
· Asymmetric tonic neck reflex (fencer position): Extension of the arm and leg on the side when the head is turned to that side with flexion of the arm and leg of the opposite side.
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